title: Factors associated with non-reimbursable activity on an inpatient pediatric consultation-liaison service.
abstract: The aim of this study was to identify factors contributing to clinician time spent in non-reimbursable activity on an inpatient pediatric consultation-liaison (C-L) service. A retrospective study was conducted using inpatient C-L service data on 1,246 consecutive referrals. For this patient population, the strongest predictor of level of non-reimbursable clinical activity was illness chronicity and the number of contacts with C-L service clinicians during their hospital stay. Patients with acute life-threatening illnesses required the highest mean amount of non-reimbursable service activity. On average, 28 % of total clinician time in completing a hospital consultation was spent in non-reimbursable activity. Effective C-L services require a proportion of time spent in non-reimbursable clinical activity, such as liaison and coordinating care with other providers. Identifying referral and systemic factors contributing to non-reimbursable activity can provide insight into budgeting/negotiating for institutional support for essential clinical and non-clinical functions in providing competent quality patient care.
authors.affiliation: Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, MLC 3015, 3333 Burnet Ave., Cincinnati, OH, 45229, USA, melanie.bierenbaum@cchmc.org.
authors.forename: Melanie L
authors.initials: ML
authors.lastname: Bierenbaum
authors.forename: Steven
authors.initials: S
authors.lastname: Katsikas
authors.forename: Allen
authors.initials: A
authors.lastname: Furr
authors.forename: Bryan D
authors.initials: BD
authors.lastname: Carter
mesh_terms: D002648:Child; D005260:Female; D006801:Humans; D007297:Inpatients; D007349:Insurance, Health, Reimbursement / Q000191:economics* / Q000706:statistics & numerical data; D008297:Male; D010372:Pediatrics / Q000191:economics* / Q000379:methods*; D011567:Psychiatric Department, Hospital / Q000191:economics / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000191:economics* / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012720:Severity of Illness Index